Ketosis

I’ve talked about Ketosis in a number of posts and I felt that a little bit more clarity of this key metabolic process was necessary. More so, since there are a number of ignorant health care providers, who get scared of the term, and will pass on their ignorance and their fears to us. If you will care to note, everywhere I’ve mentioned the term, I’ve referred to it as “Nutritional Ketosis”. That because, Nutritional ketosis is very different to “Ketoacidosis” which is what many would confuse this state with - mostly doctors (yes doctors). So let’s look at what is so different between them and why Ketosis is such a beneficial state for us to be in.

Our chemical energy is derived from the substance known as ATP (adenosine triphosphate). ATP is mostly produced and used in a metabolic pathway known as The Citric Acid Cycle or The Kreb’s cycle. This process takes place within our cell mitochondria. To do that, first, our macro nutrients must be broken down into a 2 carbon fragment known as acetyl CoA or Acetyl Coenzyme A. This acetyl CoA can be derived from Carbs (glucose), Proteins (amino acids) or Fats (fatty acids). However, the pathways of converting either of these into ATP are quite different and unique from each other. And so are the consequences.

In the absence of glucose to be used as energy, our liver starts to break down free fatty acids into ketones. These are eventually converted into the acetyl CoA, and further into ATP. This metabolic process is known as beta-oxidation. When we use this process (beta-oxidation) for deriving energy, naturally, some ketones are found floating in blood plasma, and also in urine. The body only has a 24 hour store of glucose and therefore, this is nature’s way of ensuring survival by utilizing stored fat in times of exigency. This is Nutritional Ketosis, and we try to deliberately induce it for gaining control on Blood Sugar, Obesity, Hypertension, Cholesterols and what not.

What ignorant doctors confuse this with is Diabetic Ketoacidosis (DKA). DKA is a life threatening diabetic condition for insulin dependent patients. In this case, if the patient does not receive adequate insulin, the body goes into a starvation mode, and starts to use ketones for energy. Same as in ketosis, BUT, the absence of insulin, allows for a continuous production of ketones, without stopping. Eventually, the cascading process goes out of hand, and the blood acidity levels rise to critical. If the situation is not corrected within time, the person will tend to go into a coma or death may result. This is not possible in people who can produce even small amounts of insulin.

So, on the one hand of the spectrum lies, controlled benign Nutritional Ketosis and on the other extreme is DKA. But do not ever confuse the two. Such extreme outcomes are true of any process, metabolic or not. Nutritionally, it is even possible to die with an abnormal excessive consumption of water. DKA is not possible unless you are a diabetic, only dependent on exogenous insulin, have excessively high blood sugar levels, and lack the insulin dosage as and when required. Any other aberration our body corrects preemptively. After all it likes balanced homeostasis.